Meeting Archive:
Clarifying coordination of benefits rules

Meeting Description:

Clarifying coordination of benefits rules


Coordination of benefits (COB) continues to frustrate many physicians. Sometimes this is due to confusion about the COB rules themselves, e.g., how dual coverage for dependents of married couples or dependents of divorced or separated couples fits into the mix. But sometimes payers themselves can greatly complicate a physician’s ability to be paid timely. For example, when two payers involved maintain that the other payer is “primary,” the physician often has to “wait it out” until the payers resolve that dispute. Unfortunately, by the time resolution has been achieved, the deadline for claims submission to the secondary payer has often passed and that payer will refuse to accept the claim. This webinar discusses strategies that some of your peer physicians have found helpful when dealing with COB complications, including situations in which payers dispute priority. The webinar also helps clarify confusion by describing some of the common COB rules that can facilitate payment, e.g., the so-called “birthday rule.” 

Date: Tue, Oct 23, 2012
Time: 12:00 PM CDT
Duration: 1 hour
Host(s): AMA Practice Management Center
 Presenter Information
Wes Cleveland, JD

Wes Cleveland is an attorney in the AMA’s Private Sector Advocacy unit. Prior to joining the AMA, Mr. Cleveland served as assistant attorney general in the Office of the Texas Attorney General, an attorney in the Texas Medical Association’s Office of General Counsel, and in private practice in Austin, Texas, where he represented physicians, hospitals, and individual and institutional health care providers.

Mr. Cleveland advocates for physicians on a wide variety of issues related to federal fraud and abuse, antitrust, the Employee Retirement Income and Security Act, and state and federal managed care requirements.